Longitudinal monitoring of heartbeat dynamics predicts mood changes in bipolar patients: A pilot study

Journal of Affective Disorders

Volumn 209, Issue , 2017, Pages 30-38

  Gentili, Claudio ^a   Valenza, Gaetano ^b   Nardelli, Mimma ^b   Lanatà, Antonio ^b   Bertschy, Gilles ^c   Weiner, Luisa ^c   Mauri, Mauro ^b   Scilingo, Enzo Pasquale ^b   Pietrini, Pietro ^d  

^a UNIVERSITY OF PADOVA   (Italy)

^b UNIVERSITY OF PISA   (Italy)

^c UNIVERSITÉ DE STRASBOURG   (France)

^d IMT SCHOOL FOR ADVANCED STUDIES LUCCA   (Italy)

Author keywords

Biological psychiatry; Bipolar disorders; Heart rate variability; Psychophysiology; Supported vector machine

Indexed keywords

ADULT; ARTICLE; BIPOLAR DISORDER; CLINICAL ARTICLE; CONTROLLED STUDY; DISEASE COURSE; FEMALE; HEART BEAT; HEART HEMODYNAMICS; HUMAN; LONGITUDINAL STUDY; MALE; MIDDLE AGED; MOOD CHANGE; PREDICTIVE VALUE; PRIORITY JOURNAL; SUPPORT VECTOR MACHINE; AFFECT; ELECTROCARDIOGRAPHY; HEART RATE; PATHOPHYSIOLOGY; PILOT STUDY; PSYCHOLOGICAL RATING SCALE; PSYCHOLOGY;

ADULT; AFFECT; BIPOLAR DISORDER; ELECTROCARDIOGRAPHY; FEMALE; HEART RATE; HUMANS; LONGITUDINAL STUDIES; MALE; MIDDLE AGED; PILOT PROJECTS; PSYCHIATRIC STATUS RATING SCALES; SUPPORT VECTOR MACHINE;

EID: 84996671231     PISSN: 01650327     EISSN: 15732517     Source Type: Journal    
DOI: 10.1016/j.jad.2016.11.008     Document Type: Article

References (90)

1. Adlan, A.M., Lip, G.Y.H., Paton, J.F.R., Kitas, G.D., Fisher, J.P., Autonomic function and rheumatoid arthritis-A systematic review. Semin. Arthritis Rheum. 44 (2014), 283–304.
2. Ahmed, M.W., Kadish, A.H., Parker, M.A., Goldberger, J.J., Effect of physiologic and pharmacologic adrenergic stimulation on heart rate variability. J. Am. Coll. Cardiol. 24 (1994), 1082–1090.
3. Akar, S.A., Kara, S., Latifoğlu, F., Bilgiç, V., Analysis of heart rate variability during auditory stimulation periods in patients with schizophrenia. J. Clin. Monit. Comput., 2014.
4. Alamili, M., Rosenberg, J., Gögenur, I., Day-night variation in heart rate variability changes induced by endotoxaemia in healthy volunteers. Acta Anaesthesiol. Scand. 59 (2015), 457–464.
5. Alvares, G.A., Quintana, D.S., Hickie, I.B., Guastella, A.J., Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis. J. Psychiatry Neurosci. 41 (2016), 89–104.
6. Antonijevic, I., HPA axis and sleep: identifying subtypes of major depression. Stress 11 (2008), 15–27.
7. APA, Diagnostic and statistical manual of mental disorders: dsm-iv-tr. 2000, American Psychiatric Pub., Arlington, VA.
8. Arnone, D., McIntosh, A.M., Ebmeier, K.P., Munafò, M.R., Anderson, I.M., Magnetic resonance imaging studies in unipolar depression: systematic review and meta-regression analyses. Eur. Neuropsychopharmacol. 22 (2012), 1–16.
9. Aubert, A.E., Vandeput, S., Beckers, F., Liu, J., Verheyden, B., Van Huffel, S., Complexity of cardiovascular regulation in small animals. Philos Trans. A Math. Phys. Eng. Sci. 367 (2009), 1239–1250.
10. Berry, S.M., Broglio, K., Bunker, M., Jayewardene, A., Olin, B., Rush, A.J., A patient-level meta-analysis of studies evaluating vagus nerve stimulation therapy for treatment-resistant depression. Med. Devices (Auckl.) 6 (2013), 17–35.
11. Brunoni, A.R., Kemp, A.H., Dantas, E.M., Goulart, A.C., Nunes, M.A., Boggio, P.S., Mill, J.G., Lotufo, P.A., Fregni, F., Benseñor, I.M., Heart rate variability is a trait marker of major depressive disorder: evidence from the sertraline vs. electric current therapy to treat depression clinical study. Int. J. Neuropsychopharmacol. 16 (2013), 1937–1949.
12. Chang, C., Metzger, C.D., Glover, G.H., Duyn, J.H., Heinze, H.-J., Walter, M., Association between heart rate variability and fluctuations in resting-state functional connectivity. Neuroimage 68 (2013), 93–104.
13. Chang, H.-A., Chang, C.-C., Tzeng, N.-S., Kuo, T.B.J., Lu, R.-B., Huang, S.-Y., Heart rate variability in unmedicated patients with bipolar disorder in the manic phase. Psychiatry Clin. Neurosci. 68 (2014), 674–682.
14. Clamor, A., Hartmann, M.M., Köther, U., Otte, C., Moritz, S., Lincoln, T.M., Altered autonomic arousal in psychosis: an analysis of vulnerability and specificity. Schizophr. Res. 154 (2014), 73–78.
15. Cohen, H., Kaplan, Z., Kotler, M., Mittelman, I., Osher, Y., Bersudsky, Y., Impaired heart rate variability in euthymic bipolar patients. Bipolar Disord. 5 (2003), 138–143.
16. Cristea, I.A., Valenza, G., Scilingo, E.P., Szentágotai Tătar, A., Gentili, C., David, D., Autonomic effects of cognitive reappraisal and acceptance in social anxiety: evidence for common and distinct pathways for parasympathetic reactivity. J. Anxiety Disord. 28 (2014), 795–803.
17. Crosswell, A.D., Lockwood, K.G., Ganz, P.A., Bower, J.E., Low heart rate variability and cancer-related fatigue in breast cancer survivors. Psychoneuroendocrinology 45 (2014), 58–66.
18. Daban, C., Martinez-Aran, A., Cruz, N., Vieta, E., Safety and efficacy of Vagus nerve stimulation in treatment-resistant depression. A systematic review. J. Affect. Disord. 110 (2008), 1–15.
19. Feng, J., Wang, A., Gao, C., Zhang, J., Chen, Z., Hou, L., Luo, C., Jiang, Y., Pan, J., Altered heart rate variability depends on the characteristics of coronary lesions in stable angina pectoris. Anadolu Kardiyol. Derg., 2014.
20. Goldstein, D.S., Bentho, O., Park, M.Y., Sharabi, Y., Low‐frequency power of heart rate variability is not a measure of cardiac sympathetic tone but may be a measure of modulation of cardiac autonomic outflows by baroreflexes. Exp. Physiol. 96 (2011), 1255–1261.
21. Gonçalves, T.R., Farinatti, P., Gurgel, J.L., Soares, P.Pd.S., Correlation between cardiac autonomic modulation in response to orthostatic stress and indicators of quality of life, physical capacity, and physical activity in healthy individuals. J. Strength Cond. Res., 2014.
22. Harris, P.R.E., Stein, P.K., Fung, G.L., Drew, B.J., Heart rate variability measured early in patients with evolving acute coronary syndrome and 1-year outcomes of rehospitalization and mortality. Vasc. Health Risk Manag. 10 (2014), 451–464.
23. Heathers, J.A.J., Sympathovagal balance from heart rate variability: an obituary. Exp. Physiol., 97, 2012, 556.
24. Henry, B.L., Minassian, A., Paulus, M.P., Geyer, M.A., Perry, W., Heart rate variability in bipolar mania and schizophrenia. J. Psychiatr. Res. 44 (2010), 168–176.
25. Holman, A.J., Ng, E., Heart rate variability predicts anti-tumor necrosis factor therapy response for inflammatory arthritis. Auton. Neurosci. 143 (2008), 58–67.
26. Javelot, H., Spadazzi, A., Weiner, L., Garcia, S., Gentili, C., Kosel, M., Bertschy, G., Telemonitoring with respect to mood disorders and information and communication technologies: overview and presentation of the PSYCHE project. BioMed Res. Int., 2014, 2014, 104658.
27. Jiang, W., Impacts of depression and emotional distress on cardiac disease. Clevel. Clin. J. Med. 75:Suppl 2 (2008), S20–S25.
28. Jiang, X.-L., Zhang, Z.-G., Ye, C.-P., Lei, Y., Wu, L., Zhang, Y., Chen, Y.-Y., Xiao, Z.-J., Attenuated or absent HRV response to postural change in subjects with primary insomnia. Physiol. Behav. 140C (2015), 127–131.
29. Jones, K.I., Amawi, F., Bhalla, A., Peacock, O., Williams, J.P., Lund, J.N., Assessing surgeon stress when operating using Heart rate variability and the state trait anxiety Inventory: will surgery be the death of us?. Colorectal Dis., 2014.
30. Karavidas, M.K., Lehrer, P.M., Vaschillo, E., Vaschillo, B., Marin, H., Buyske, S., Malinovsky, I., Radvanski, D., Hassett, A., Preliminary results of an open label study of heart rate variability biofeedback for the treatment of major depression. Appl. Psychophysiol. Biofeedback 32 (2007), 19–30.
31. Kemp, A.H., Quintana, D.S., The relationship between mental and physical health: insights from the study of heart rate variability. Int. J. Psychophysiol. 89 (2013), 288–296.
32. Kemp, A.H., Quintana, D.S., Gray, M.A., Felmingham, K.L., Brown, K., Gatt, J.M., Impact of depression and antidepressant treatment on heart rate variability: a review and meta-analysis. Biol. Psychiatry 67 (2010), 1067–1074.
33. Kemp, A.H., Quintana, D.S., Quinn, C.R., Hopkinson, P., Harris, A.W.F., Major depressive disorder with melancholia displays robust alterations in resting state heart rate and its variability: implications for future morbidity and mortality. Front. Psychol., 5, 2014, 1387.
34. Kenney, M.J., Ganta, C.K., Autonomic nervous system and immune system interactions. Compr. Physiol. 4 (2014), 1177–1200.
35. Khaykin, Y., Dorian, P., Baker, B., Shapiro, C., Sandor, P., Mironov, D., Irvine, J., Newman, D., Autonomic correlates of antidepressant treatment using heart-rate variability analysis. Can. J. Psychiatry 43 (1998), 183–186.
36. Koukopoulos, A., Reginaldi, D., Tondo, L., Visioli, C., Baldessarini, R.J., Course sequences in bipolar disorder: depressions preceding or following manias or hypomanias. J. Affect Disord. 151 (2013), 105–110.
37. Lanata, A., Valenza, G., Nardelli, M., Gentili, C., Scilingo, E.P., Complexity index from a personalized wearable monitoring system for assessing remission in mental health. IEEE J. Biomed. Health Inf. 19 (2015), 132–139.
38. Latalova, K., Prasko, J., Diveky, T., Grambal, A., Kamaradova, D., Velartova, H., Salinger, J., Opavsky, J., Autonomic nervous system in euthymic patients with bipolar affective disorder. Neuro Endocrinol. Lett. 31 (2010), 829–836.
39. Lehrer, P.M., Gevirtz, R., Heart rate variability biofeedback: how and why does it work. Front. Psychol., 5, 2014, 756.
40. Leistedt, S.J.-J., Linkowski, P., Lanquart, J.-P., Mietus, J.E., Davis, R.B., Goldberger, A.L., Costa, M.D., Decreased neuroautonomic complexity in men during an acute major depressive episode: analysis of heart rate dynamics. Transl. Psychiatry, 1, 2011, e27.
41. Liang, C.-S., Lee, J.-F., Chen, C.-C., Chang, Y.-C., Reactive heart rate variability in male patients with first-episode major depressive disorder. Prog. Neuropsychopharmacol. Biol. Psychiatry 56 (2015), 52–57.
42. Lichtman, J.H., Froelicher, E.S., Blumenthal, J.A., Carney, R.M., Doering, L.V., Frasure-Smith, N., Freedland, K.E., Jaffe, A.S., Leifheit-Limson, E.C., Sheps, D.S., Vaccarino, V., Wulsin, L., Epidemiology, A.H.A.S.CotCo, Prevention, Cardiovascular, tCo, Nursing, S., Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association. Circulation 129 (2014), 1350–1369.
43. Liu, Y.-C., Hung, C.-S., Wu, Y.-W., Lee, Y.-C., Lin, Y.-H., Lin, C., Lo, M.-T., Chan, C.-C., Ma, H.-P., Ho, Y.-L., Chen, C.-H., Influence of non-alcoholic fatty liver disease on autonomic changes evaluated by the time domain, frequency domain, and symbolic dynamics of heart rate variability. PLoS One, 8, 2013, e61803.
44. Lo, S.-H., Lin, L.-Y., Hwang, J.-S., Chang, Y.-Y., Liau, C.-S., Wang, J.-D., Working the night shift causes increased vascular stress and delayed recovery in young women. Chrono-. Int 27 (2010), 1454–1468.
45. Lotufo, P.A., Valiengo, L., Benseñor, I.M., Brunoni, A.R., A systematic review and meta-analysis of heart rate variability in epilepsy and antiepileptic drugs. Epilepsia 53 (2012), 272–282.
46. Maes, J., Verbraecken, J., Willemen, M., De Volder, I., van Gastel, A., Michiels, N., Verbeek, I., Vandekerckhove, M., Wuyts, J., Haex, B., Willemen, T., Exadaktylos, V., Bulckaert, A., Cluydts, R., Sleep misperception, EEG characteristics and Autonomic Nervous System activity in primary insomnia: a retrospective study on polysomnographic data. Int. J. Psychophysiol. 91 (2014), 163–171.
47. Martin, J.L.R., Martín-Sánchez, E., Systematic review and meta-analysis of vagus nerve stimulation in the treatment of depression: variable results based on study designs. Eur. Psychiatry 27 (2012), 147–155.
48. McCraty, R., Shaffer, F., Heart Rate Variability: New Perspectives on Physiological Mechanisms, Assessment of Self-regulatory Capacity, and Health risk. Glob. Adv. Health Med. 4 (2015), 46–61.
49. McKinnon, M.C., Yucel, K., Nazarov, A., MacQueen, G.M., A meta-analysis examining clinical predictors of hippocampal volume in patients with major depressive disorder. J. Psychiatry Neurosci. 34 (2009), 41–54.
50. Montano, N., Porta, A., Cogliati, C., Costantino, G., Tobaldini, E., Casali, K.R., Iellamo, F., Heart rate variability explored in the frequency domain: a tool to investigate the link between heart and behavior. Neurosci. Biobehav. Rev. 33 (2009), 71–80.
51. Moon, E., Lee, S.-H., Kim, D.-H., Hwang, B., Comparative Study of Heart Rate Variability in Patients with Schizophrenia, Bipolar Disorder, Post-traumatic Stress Disorder, or Major Depressive Disorder. Clin. Psychopharmacol. Neurosci. 11 (2013), 137–143.
52. Ozerdema, A., Güntekind, B., Atagüne, M.I., Başar, E., Brain oscillations in bipolar disorder in search of new biomarkers. Suppl. Clin. Neurophysiol. 62 (2013), 207–221.
53. Parker, S.L., Laurie, K.R., Newton, C.J., Jimmieson, N.L., Regulatory focus moderates the relationship between task control and physiological and psychological markers of stress: a work simulation study. Int. J. Psychophysiol. 94 (2014), 390–398.
54. Patron, E., Messerotti Benvenuti, S., Favretto, G., Valfrè, C., Bonfà, C., Gasparotto, R., Palomba, D., Association between depression and heart rate variability in patients after cardiac surgery: a pilot study. J. Psychosom. Res. 73 (2012), 42–46.
55. Peterson, J.C., Charlson, M.E., Wells, M.T., Altemus, M., Depression, coronary artery disease, and physical activity: how much exercise is enough?. Clin. Ther. 36 (2014), 1518–1530.
56. Quintana, D.S., Westlye, L.T., Kaufmann, T., Rustan, Ø.G., Brandt, C.L., Haatveit, B., Steen, N.E., Andreassen, O.A., Reduced heart rate variability in schizophrenia and bipolar disorder compared to healthy controls. Acta Psychiatr. Scand., 2015.
57. Radaelli, A., Mancia, G., Balestri, G., Rovati, A., Anzuini, A., Di Rienzo, M., Paolini, G., Castiglioni, P., Cardiovascular variability is similarly altered in coronary patients with normal left ventricular function and in heart failure patients. J. Hypertens. 32 (2014), 2261–2266 (discussion 2266).
58. Rahman, F., Pechnik, S., Gross, D., Sewell, L., Goldstein, D.S., Low frequency power of heart rate variability reflects baroreflex function, not cardiac sympathetic innervation. Clin. Auton. Res. 21 (2011), 133–141.
59. Rajendra Acharya, U., Paul Joseph, K., Kannathal, N., Lim, C.M., Suri, J.S., Heart rate variability: a review. Med. Biol. Eng. Comput. 44 (2006), 1031–1051.
60. Reyes del Paso, G.A., Langewitz, W., Mulder, L.J., van Roon, A., Duschek, S., The utility of low frequency heart rate variability as an index of sympathetic cardiac tone: a review with emphasis on a reanalysis of previous studies. Psychophysiology 50 (2013), 477–487.
61. Rovai, D., Giannessi, D., Andreassi, M.G., Gentili, C., Pingitore, A., Glauber, M., Gemignani, A., Mind injuries after cardiac surgery. J. Cardiovasc. Med. (Hagerstown, Md. ) 16 (2015), 844–851.
62. Rush, A.J., Trivedi, M.H., Ibrahim, H.M., Carmody, T.J., Arnow, B., Klein, D.N., Markowitz, J.C., Ninan, P.T., Kornstein, S., Manber, R., Thase, M.E., Kocsis, J.H., Keller, M.B., The 16-Item Quick Inventory of depressive symptomatology (QIDS), clinician rating (QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in patients with chronic major depression. Biol. Psychiatry 54 (2003), 573–583.
63. Salvioli, B., Pellegatta, G., Malacarne, M., Pace, F., Malesci, A., Pagani, M., Lucini, D., Autonomic nervous system dysregulation in irritable bowel syndrome. Neurogastroenterol. Motil., 2015.
64. Sanchez-Gonzalez, M.A., Guzik, P., May, R.W., Koutnik, A.P., Hughes, R., Muniz, S., Kabbaj, M., Fincham, F.D., Trait anxiety mimics age-related cardiovascular autonomic modulation in young adults. J. Hum. Hypertens., 2014.
65. Sandercock, G.R.H., Brodie, D.A., The role of heart rate variability in prognosis for different modes of death in chronic heart failure. Pacing Clin. Electro. 29 (2006), 892–904.
66. Sartori, G., Pellegrini, S., Mechelli, A., Forensic neurosciences: from basicresearch to applications and pitfalls. Curr. Opin. Neurol. 24:4 (2011), 371–377.
67. Saul, J.P., Berger, R.D., Albrecht, P., Stein, S.P., Chen, M.H., Cohen, R.J., Transfer function analysis of the circulation: unique insights into cardiovascular regulation. Am. J. Physiol. 261 (1991), H1231–H1245.
68. Stapelberg, N.J., Hamilton-Craig, I., Neumann, D.L., Shum, D.H., McConnell, H., Mind and heart: heart rate variability in major depressive disorder and coronary heart disease - a review and recommendations. Aust. N. Z. J. Psychiatry 46 (2012), 946–957.
69. Tan, C.O., Cohen, M.A., Eckberg, D.L., Taylor, J.A., Fractal properties of human heart period variability: physiological and methodological implications. J. Physiol. 587 (2009), 3929–3941.
70. Tanev, G., Saadi, D.B., Hoppe, K., Sorensen, H.B.D., Classification of acute stress using linear and non-linear heart rate variability analysis derived from sternal ECG. Conf. Proc. IEEE Eng. Med Biol. Soc. 2014 (2014), 3386–3389.
71. Tang, S.-C., Jen, H.-I., Lin, Y.-H., Hung, C.-S., Jou, W.-J., Huang, P.-W., Shieh, J.-S., Ho, Y.-L., Lai, D.-M., Wu, A.-Y., Jeng, J.-S., Chen, M.-F., Complexity of heart rate variability predicts outcome in intensive care unit admitted patients with acute stroke. J. Neurol. Neurosurg. Psychiatry 86 (2015), 95–100.
72. Task Force of the European Society of Cardiology, aT.FotE.So.C., Heart rate variability: standards of measurement, physiological interpretation and clinical use. task force of the European Society of Cardiology and the North American Society of pacing and Electrophysiology. Circulation 93 (1996), 1043–1065.
73. Teixeira, A.L., Barbosa, I.G., Machado-Vieira, R., Rizzo, L.B., Wieck, A., Bauer, M.E., Novel biomarkers for bipolar disorder. Expert Opin. Med Diagn. 7 (2013), 147–159.
74. Thayer, J.F., Ahs, F., Fredrikson, M., Sollers, J.J., Wager, T.D., A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. Neurosci. Biobehav. Rev. 36 (2012), 747–756.
75. Thayer, J.F., Lane, R.D., Claude Bernard and the heart-brain connection: further elaboration of a model of neurovisceral integration. Neurosci. Biobehav. Rev. 33 (2009), 81–88.
76. Todder, D., Bersudsky, Y., Cohen, H., Nonlinear analysis of RR interval in euthymic bipolar disorder. Auton. Neurosci. 117 (2005), 127–131.
77. Udupa, K., Sathyaprabha, T.N., Thirthalli, J., Kishore, K.R., Raju, T.R., Gangadhar, B.N., Modulation of cardiac autonomic functions in patients with major depression treated with repetitive transcranial magnetic stimulation. J. Affect. Disord. 104 (2007), 231–236.
78. Valenza, G., Citi, L., Gentili, C., Lanata, A., Scilingo, E.P., Barbieri, R., Point-process nonlinear autonomic assessment of depressive states in bipolar patients. Methods Inf. Med. 53 (2014), 296–302.
79. Valenza, G., Citi, L., Gentili, C., Lanata, A., Scilingo, E.P., Barbieri, R., Characterization of depressive States in bipolar patients using wearable textile technology and instantaneous heart rate variability assessment. IEEE J. Biomed. Health Inf. 19 (2015), 263–274.
80. Valenza, G., Gentili, C., Lanatà, A., Scilingo, E.P., Mood recognition in bipolar patients through the PSYCHE platform: preliminary evaluations and perspectives. Artif. Intell. Med. 57 (2013), 49–58.
81. Valenza, G., Nardelli, M., Lanata, A., Gentili, C., Bertschy, G., Kosel, M., Scilingo, E.P., Predicting mood changes in bipolar disorder Through heartbeat nonlinear dynamics. IEEE J. Biomed. Health Inform. 20 (2016), 1034–1043.
82. Valenza, G., Nardelli, M., Lanata, A., Gentili, C., Bertschy, G., Paradiso, R., Scilingo, E.P., Wearable monitoring for mood recognition in bipolar disorder based on history-dependent long-term heart rate variability analysis. IEEE J. Biomed. Health Inform. 18 (2014), 1625–1635.
83. Valenza, G., Nardelli, M., Lanata, A., Gentili, C., Bertschy, G., Scilingo, E.P., 2015b. Predicting mood changes in bipolar disorder through heartbeat nonlinear dynamics: A preliminary study, Computing in Cardiology Conference (CinC), 2015. IEEE, pp. 801–804.
84. Wang, Y., Zhao, X., O'Neil, A., Turner, A., Liu, X., Berk, M., Altered cardiac autonomic nervous function in depression. BMC Psychiatry, 13, 2013, 187.
85. Warren, J.H., Jaffe, R.S., Wraa, C.E., Stebbins, C.L., Effect of autonomic blockade on power spectrum of heart rate variability during exercise. Am. J. Physiol. 273 (1997), R495–R502.
86. Wendt, H., Kiyono, K., Abry, P., Hayano, J., Watanabe, E., Yamamoto, Y., MultiScale wavelet p-leader based heart rate variability analysis for survival probability assessment in CHF patients. Conf. Proc. IEEE Eng. Med Biol. Soc. 2014 (2014), 2809–2812.
87. Yang, A.C., Huang, C.-C., Yeh, H.-L., Liu, M.-E., Hong, C.-J., Tu, P.-C., Chen, J.-F., Huang, N.E., Peng, C.-K., Lin, C.-P., Tsai, S.-J., Complexity of spontaneous BOLD activity in default mode network is correlated with cognitive function in normal male elderly: a multiscale entropy analysis. Neurobiol. Aging 34 (2013), 428–438.
88. Yang, A.C., Tsai, S.-J., Is mental illness complex? From behavior to brain. Prog. Neuropsychopharmacol. Biol. Psychiatry 45 (2013), 253–257.
89. Young, R.C., Biggs, J.T., Ziegler, V.E., Meyer, D.A., A rating scale for mania: reliability, validity and sensitivity. Br. J. Psychiatry 133 (1978), 429–435.
90. Zhang, L.-N., Yang, G., Cheng, C., Shen, C., Cui, Y.-Y., Zhang, J., Zhang, J.-J., Shen, Z.-X., Zeng, M., Ge, Y.-F., Sun, B., Yu, X.-B., Ouyang, C., Zhang, B., Mao, H.-J., Liu, J., Xing, C.-Y., Zha, X.-M., Wang, N.-N., Plasma FGF23 levels and heart rate variability in patients with stage 5 CKD. Osteoporos. Int. 26 (2015), 395–405.